A condition in which one of the major nerves that controls the functioning of the hand and fingers the (median nerve), becomes compressed inside a tunnel in the wrist.

The carpal tunnel is a small passage inside the wrist. In addition, several fine bones of the wrist from the floor and the sides of the tunnel.

The median nerve supplies most if the feeling of the hand, particularly to the thumb, index and middle fingers, the thumb half of the palm, and the outer side of the hand.

3Facts about CTS

According to the Health Center of arthritis and pain in 2004, CTS results in more than two million visits to the physicians offices each year.

CTS strikes approximately three times as many women as men.

CTS is one of the most-common job related injuries.

Although it may be aggravated by work, CTS, frequently occurs in people who are not working with their hands.

4CTS Facts Continue

Approximately 260,000 carpal tunnel surgeries are performed each year in the U.S.

Almost half of CTS cases results in 31 days or more of work loss.

If not properly treated, CTS, can cause irreversible nerve damage and permanent disability of varying degrees.

5What are the symptoms of CTS

Numbness

Tingling

Burning sensation in the thumb and fingers

Pain in the hands or wrists

Loss of dexterity of gripping strength

Pain in the arm and shoulder

Swelling of the hand, which often increases at night

6How is the diagnosis made?

First the doctor will take medical history asking about

The symptoms and what brings them on

How long youve had them

Your general medical background

In addition, the physician will examine your hands, wrists, elbows, shoulders, and neck to check for nerve compression

7Continue of diagnosis

Examination will also include

Tapping your wrist over the median nerve to see if this reproduces your symptoms

Final test

Gently holding your wrist bent forward for 30 to 60 seconds to see if this reproduces your symptoms

Phalen test

Gently using pinpricks and light stroking motions with a pin to see if any part of the hand has lost sensitivity or a sign of nerve damage

8What causes CTS

We do not always know what causes CTS. In fact, in most cases no obvious cause can be found

But any condition that lessens the amount of space in the carpal tunnel can compress the median nerve, this include

Previous fractures of the wrist

Medications that may lead to fluid retention

Including oral contraceptives (birth control pills)

Hormonal changes

Medical disorders

Which involves constricted blood vessels, such as Raynauds disease

9Surgery for CTS

Surgery is reserved for last resort if

Other treatments fail

Hand function continues to deteriorate

In most people, surgery completely abolishes the symptoms of CTS. However, you should be aware that

In long-standing cases, if the nerve has suffered form irreversible damage and is no longer to function normally, loss of sensation and weakness in the fingers will persist.

A few people experience a return of CTS symptoms after a period of time

10Types of surgeries for CTS

Open carpal tunnel release surgery

Endoscopic or Keyhole surgery

The goal of this procedure is to increase the space in the carpal tunnel to remove pressure if the median nerve, which is compressed in the tunnel at the wrist

This operation is relatively simple and is usually done on an outpatient basis

11How the operation is performed

Local anesthetic

With the injection of a numbing sunbstance directly into the hand where the incision needs to be made

Regional anesthetic

With the injection of a numbing substance into the upper arm to numb the entire arm

General anesthetic

With the patient asleep

12After the operation

The hand may be dressed with bandages and a splint or plaster cast, usually for a week or two. In addition, the arm should be elevated to reduce the swelling, and a sling may be worn for comfort.

Precautions

Avoid leaving the arm hanging down, since the positions encourages to remain in the hand

Be careful not to wet the dressing cover the dressing with a plastic bag when washing

13Photos of CTS 14Good to Know

Oral steroids may help when CTS is caused by rheumatoid arthritis, but should not be taken for CTS caused by repetitive stain or excess fluid in the body. Furthermore, the use of oral steroids for CS, which is very rarely prescribed, must be carefully monitored by the phycisian

15Alternative Treatments

Cold laser therapy

Noninvasive, low energy (cold) laser light is used to penetrate the skin and soft tissue

Acupuncture

This is a ancient Chinese treatment in which the acupuncturists believe that energy flows through the body along the pathways called meridians

Vitamin B6(pyridoxine)

Some researches claim B6 relieves CTS. It is not advisable to take more 200 milligrams per day. More than this amount can cause nerve damage.

Magnet therapy

Some people believe that magnets of at least 550 to 850 gauss stimulate blood flow and offer pain relief.

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